Data from a long-term prospective study reveal that for many older women, the pace of bone mass deterioration takes place on the scale of decades, not single years. Here, the lead author of the study describes how to interpret the results to choose the date for your own patient's next bone density test.
Among women with normal initial bone mass who took part in a major osteoporosis study, only 10% developed osteoporosis within 15 years. What are the implications of this knowledge for best practices in osteoporosis screening? Dr Margaret Gourlay, lead author of the report in The New England Journal of Medicine, tells what you should take into account as you work with patients to decide how often they need a bone density test. Dr Gourlay is Assistant Professor of Family Medicine at the University of North Carolina at Chapel Hill.
"Take home" Points:
1. No previous studies have documented the best screening intervals for osteoporosis.
2. For women aged 67 and older who have an initial T score greater than -1.5, retrospective analysis of data from a large cohort study suggests the next bone density test may not be informative within the next 15 years. In general, these women progress very slowly to osteoporosis.
3. For women with lower initial T scores, especially older women, screening is justified more often.
4. All women aged 65 and older should have an initial bone density test. Too few women in this age group are receiving bone density measurements.
Judging Osteoporosis Screening Intervals From the Latest T Score
For your reference:
Osteoporosis Study Suggests Bone Density Testing Intervals for Older WomenMusculoskeletal Network, January 31, 2012
Bone-Density Testing Interval and Transition to Osteoporosis in Older Women
Gourlay ML, Fine JP, et al. N Engl J Med. January 19, 2012